And some of us believe that real data-, science-, and ethics-driven leadership could have mitigated, and could continue to mitigate, both health and economic outcomes.
But the health vs. economics mantra has prevailed. Sadly.
I really think it will be years before we’ll have more clearly defined risk levels of death and disability.
What I hope for in the shorter term (next few months) is advances in treatment options, more clarity on immunity after infection, better tests and testing capacity, and huge quantities of PPE.
In the intermediate term (next couple of years), I hope for a vaccine. (One can dream. ???)
You mean that you believe that there will be no medical advances in risk assessment, prevention, diagnosis, and/or treatment that will make it less likely to get infected later or less likely to have a bad result if you are infected later, compared to earlier?
So are you saying that we should give up on the goal of medical advances that clarify and reduce the risk of bad results of infection?
To me, it boils down to one essential question: at what point is the public risk low enough that the government should allow people to make their own private risk assessments?
That’s not an all or nothing question, of course. Going to a park with a mask and maintaining distance represents one level of risk. Having people packed into a stadium or theatre is another. I tend to think that at this point, most places should be permitting certain things closer to the former, and banning things closer to the latter.
I acknowledge that even allowing very modest steps toward reopening will likely lead to some increase in deaths. My question addresses at what point the relative risk to ourselves and others becomes similar to risks that all of us accept as a matter of course. As many here have noted, in ordinary times, we don’t actually operate on the principle that we should all conduct ourselves only in those ways that are most likely to avoid the greatest number of casualities. If we did, we’d stop non-essential driving, stay indoors every flu season, and severely limit contact between young children and elderly relatives. Plainly, the overall risk of Corona is much higher - but possibly not the risk of catching Corona because people were allowed to walk in parks or more businesses were allowed to offer limited services with precautions.
Certainly, we don’t typically allow government to legislate that personal behavior accord with the good of society - if we did, we would probably legislate the amount of fat and sugar that people would consume, require gym attendence, and ban all risky activities, on the logic that people who ski, or boat, or bike are more likely to use hospital resources, be left with disabilities that will require assistance, or leave their families without sufficient means of support.
On the personal level, I don’t think it is terribly selfish or foolhardy to decide that, even if you’re in a higher risk group, you’re simply not willing to live in isolation for what could turn out to be years. That doesn’t mean going back to normal, but it means working out a new normal that doesn’t require that you never see your grandchildren or walk in the fresh air again.
It’s ironic that the risk of typhus was waved off in downtown LA just a few months ago. The rats were thriving on Skid Row. But forcing people to stop living on the sidewalks was deemed an infringement on their liberties or something by the ACLU and others.
Unemployment is going to be very high whether we open up or not, because lots of people who can afford to spend money on services don’t want to do it. Therefore, these families are still going to be food insecure unless we act to give them more food, which is what we should do, by means such as better unemployment compensation and better SNAP.
California’s unemployment insurance program has already run dry. California had to get a federal loan to keep it going.
What’s happening in my neck of the woods: Someone posted an idea on our town FB group for a socially-distanced high school commencement. A frontline physician commented all of the reasons why what was proposed wasn’t advisable at this time and it would be best to wait until it was safer to gather. They are now coming for her with pitchforks, with comments like, “No one asked for your negativity” and such.
Look, I’m as disappointed as anyone else that my D20 is not having the capstone experiences we expected. Life is full of disappointments and the sooner one learns that, the better off they’ll be in the long run, IMHO.
I was in this group for the first few months of the outbreak. My observation of our federal and local governments now leads me to believe they are either incapable of or unwilling to do this. I’m no longer holding out hope for this or advocating for it. The will and ability is nonexistant and it’s unrealistic to remain on permanent lockdown until this fantasy becomes reality.
I think we’ll be very lucky if we have a vaccine anytime in the next 12 months.
I think doctors now have a pretty good idea who is at risk, and why, and what protocols to use to help those infected who can be helped. They can’t save everybody, and hoping for that is not realistic. So no, I do not think things will be much different in 6 or 12 months. Maybe with a vaccine in 2 or 3 years, we can prevent some of the illness and death.
You don’t think there will be more PPE? You don’t think there will be A LOT more testing? You don’t think contact tracers will be trained and working?
Or is it that you don’t think PPE, testing, contact tracing and isolation make a difference?
CNN says that no state that is opening has met the federal guidelines to do so.
I thought the criteria for not isolating any longer after a positive dx of Covid 19 was several days without ANY symptoms. I didn’t think you were allowed to pick and choose the symptoms. You had to be completely symptom free.
If you had a positive test, and your taste and smell aren’t back…you still have symptoms. Stay home.
Agreed.
Anything under a handful of years means the vaccine would be launching without the typical safety data historically required for vaccines.
What does that mean? A greater proportion than usual of people probably won’t get this vaccine…and IMO that would be a reasonable decision to not participate in what would effectively be ongoing clinical trials testing the safety of the vaccine.
Even once a vaccine is approved, it will likely take a long time to manufacture 250-300+ million doses (even if the company ramps up manufacturing prior to approval) and then logistically get that many people vaccinated. This all assumes of course that it’s a US company that develops the vaccine(s).
Perhaps one of the current vaccines (OPV, BGC, etc) will demonstrate efficacy in preventing covid-19…that could represent our quickest and safest ‘hope’.
In 6 months, I don’t think the PPE situation will be significantly different. We still don’t make much of that in the US with no significant plans that I can see to change that and as the pandemic travels around the world, demand will be high from everywhere. We also have an administration that seems to be intent on making an enemy of the world’s largest producer of much of the PPE. So no - not much change in 6 months. Possibly in a year.
And again, I see neither the will nor the ability of federal or most local governments to implement the quality and quantity of testing needed much less contact tracing to meaningfully result in a containment.
I would love to be wrong. And I was one of the big proponents for test, trace and confine from the beginning. But you have to work with the reality you see, not the reality you’d like to have. The reality I see is that our government at many levels is not going to address PPE or testing in a way that will contain this, so there’s no sense waiting for that to happen. Time to move on to the reality and doing the best possible to balance protecting people and keeping what little we can of the economy going.
That’s interesting about typhus, TatinG… if you see any other mentions of how covid mitigation has changed the realities of the homeless/homeless public health issues, do share. This inquiring mind wants to know 
That’s because what the federal guidelines said, in writing, and what some federal officials said, in person, were two different things.
I thought this too about PPE…but interestingly some recent college updates said they are actively purchasing PPE so that they have adequate supply for the Fall. I don’t know where they are purchasing from, whether they are overpaying, or whether they are competing with state governments. A number of schools donated all their PPE to local hospitals over the last several months so are starting out basically with nothing.